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Once you have registered through our online registration system, we will contact you to follow up on the rest of the application procedure.
Full Name (as in IC) :
Date of Birth : 01020304050607080910111213141516171819202122232425262728293031 / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / 2000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949
Identity Card No :
Student Mobile No :
Parent Telephone No :
Email :
Address :
City/Town : PostCode :
State : Country : AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe
School/College :
State : -JohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakTerengganuSelangorWP Kuala LumpurWP LabuanWP Putrajaya
SPM : (sum the number of subjects with A, B and C into the appropriate box below) A+ to A- = B+ to B- = C+ to C- =
English : Credit Pass Failed
Mathematics : Credit Pass Failed
Science / Additional Science / Physics / Chemistry / Biology : Credit Pass Failed
STPM (if applicable) : (Principal is the subject of grade A to C)
1st Choice : ---English Improvement ProgrammesFoundation in ScienceFoundation in BusinessFoundation in Information TechnologyDiploma in NursingDiploma in Business ManagementDiploma in Human Resource ManagementDiploma in ManagementDiploma in AccountingDiploma in Environment HealthDiploma in Occupational Health & SafetyDiploma in Architectural TechnologyDiploma in Civil EngineeringDiploma in Information TechnologyDiploma in Medical Laboratory TechnologyBachelor of BusinessBachelor of ManagementBachelor in AccountingBachelor of Business AdministrationBachelor of Science (Architectural Design)Bachelor of Computer Science (Software Engineering)Bachelor of Computer Science (Business Info Technology)Bachelor of Environmental Health (B.EVH.Hons)Bachelor of Science in Accounting & FinanceBachelor of Biomedical ScienceBachelor of Occupational Health & SafetyBachelor of Communication (Journalism)Master of Business AdministrationMaster in Information TechnologyDoctor of Business Administration
2nd Choice : ---English Improvement ProgrammesFoundation in ScienceFoundation in BusinessFoundation in Information TechnologyDiploma in NursingDiploma in Business ManagementDiploma in Human Resource ManagementDiploma in ManagementDiploma in AccountingDiploma in Environment HealthDiploma in Occupational Health & SafetyDiploma in Architectural TechnologyDiploma in Civil EngineeringDiploma in Information TechnologyDiploma in Medical Laboratory TechnologyBachelor of BusinessBachelor of ManagementBachelor in AccountingBachelor of Business AdministrationBachelor of Science (Architectural Design)Bachelor of Computer Science (Software Engineering)Bachelor of Computer Science (Business Info Technology)Bachelor of Environmental Health (B.EVH.Hons)Bachelor of Science in Accounting & FinanceBachelor of Biomedical ScienceBachelor of Occupational Health & SafetyBachelor of Communication (Journalism)Master of Business AdministrationMaster in Information TechnologyDoctor of Business Administration
The personal data you have provided in this form will be used by or on behalf of City UC to send you further details, including its events, academic programmes and marketing information.
Maklumat peribadi yang anda berikan pada borang ini akan digunakan oleh atau pihak-pihak yang berkaitan dengan City UC untuk menghantar kepada anda maklumat lanjut berkaitan acara-acara yang akan dianjurkan, program akademik dan maklumat pemasaran.
I declare that the information provided by me in this application form is true and correct. I acknowledge and agree :- a) That City UC reserves the right to vary or reserve any decision regarding admission or enrollment made on the basis of incorrect or incomplete information given by me. b) To abide by all academic, administrative and examination rules and regulations of the programme and to uphold the integrity and good name of City UC at all times. c) City UC shall have absolute right as it deems fit to defer, close or not to commence any programme; and to review, change and update subject curriculum in any programme. e) To abide by the City UC Code of Honour, as outlined in the General Rules and Regulations in the relevant City UC Student Handbook.
Yes, I understand and agree on the above terms & conditions (Section 5 & 6. Declaration and Agreement by Applicant)